Trustees Report & Trust Funds

The Medicare Program is the second-largest social insurance program in the U.S., with 66.7 million beneficiaries and total expenditures of just over $1.0 trillion in 2023. The Boards of Trustees for Medicare (also Boards) report annually to the Congress on the financial operations and actuarial status of the program. Beginning in 2002, there is one combined report discussing both the Hospital Insurance program (Medicare Part A) and the Supplementary Medical Insurance program (Medicare Part B and Prescription Drug Coverage). The Office of the Actuary in the Centers for Medicare & Medicaid Services (CMS) prepares the report under the direction of the Boards.

The Boards of Trustees issued their most recent report on May 6, 2024. (See downloads below.)

The Trustees Report is a detailed, lengthy document, containing a substantial amount of information on the past and estimated future financial operations of the Hospital Insurance and Supplementary Medical Insurance Trust Funds (see the links in the Downloads section below). We recommend that readers begin with the "Overview" section of the report. This section is fairly short, is written in "plain English," and summarizes all the key information concerning the expected financial outlook for Medicare. Substantial additional material is available in the later sections for those wishing to delve more deeply into the actuarial projections.

The following expanded and supplementary tables and figures have been provided to accompany the report. (See downloads below.)

• HI and SMI Average per Beneficiary Costs
• HI and SMI Incurred Expenditures as a Percentage of the Gross Domestic Product
• Operations of the Supplementary Medical Insurance (SMI) Trust Fund
• Components of Historical and Projected Increases in HI Inpatient Hospital Payments
• Medicare Enrollment by Part and in Total
• Ratio of HI Covered Workers to HI Beneficiaries
• Ratio of Assets at the Beginning of the Year to Expenditures During the Year for the HI Trust Fund
• Ratio of HI Taxable Payroll to GDP
• Relationship between Increases in HI Expenditures and Increases in Taxable Payroll
• Total Medicare Income, Expenditures and Trust Fund Assets
• Operations of the Hospital Insurance (HI) Trust Fund
• HI Cost and Income Rates
• Medicare Sources of Non-Interest Income as a Percentage of Total Income and as a Percentage of Gross Domestic Product
• Operations of the Part D Account of the Supplementary Medical Insurance (SMI) Trust Fund
• Operations of the Part B Account of the Supplementary Medical Insurance (SMI) Trust Fund
• Hospital Insurance Cost-sharing and Premium Amounts
• SMI Cost-sharing and Premium Amounts
• 2024 Trustees Report Figures
• HI and SMI Incurred Expenditures as a Percentage of the Gross Domestic Product under Illustrative Alternative

The Social Security Administration publishes the following:

• Old-Age, Survivors & Disability Insurance (OASDI) Trustees Report (See Related Links below)
• Status of the Social Security and Medicare Programs (See Related Links below)

Related information:

• Actuarial studies (See Related Links below)